The momentum developed in the patient safety movement presents an important opportunity to highlight problems and work cooperatively to improve patient outcomes. It may be difficult, however, to agree when errors occur, and even more difficult to develop workable and cost- effective systematic approaches to their prevention. In response to an RFA from the Agency for Healthcare Research and Quality, we are proposing a Developmental Center for Evaluation and Research in Patient Safety (DCERPS). The name of our center "Targeting Interventions to Reduce Errors" (TITRE) highlights a common focus on identifying efficient approaches to reduce errors through targeting. The term targeting captures our dedication to ensuring that we spend our limited time and energy on problems that have the greatest impact and where interventions are likely to do the most good. As a corollary, this approach requires the ability to identify patterns that are both specific and common when studying problems and ensuring that interventions to ameliorate problems do not saturate the ability of the system to respond. The TITRE DCERPS includes investigators with a wide variety of research skills including health services research, clinical epidemiology, medical sociology, operations research and high reliability systems, cognitive psychology, ethics, medical education, and economics. We have eight affiliated research units and organizations including the University of Michigan Medical Center, the VA National Center for Patient Safety, the California Pacific Health System, and St. Joseph's Medical Center. Our planning phase involves several strategies and initiatives, including a series of retreats organized around project-specific "Requests for Proposals" and a series of patient safety related topics that are particularly relevant to our research objectives. We will involve both medical content experts and error-reduction specialists from industry and non-clinical academic areas. Problems will be presented by the former and solutions proposed by the latter. We will also have a multi-disciplinary planning committee with representatives from a wide variety of disciplines outside of medicine. We believe that the researchers and organizations that we have identified along with the strategies and initiatives outlined in the proposal will allow us to significantly enhance our research capacity in patient safety.